1. Parsonage-Turner syndrome following chikungunya virus infection: A case report
Luis Arthur Brasil Gadelha FARIAS ; Roberto Da Justa PIRES NETO ; Jorge Luiz Nobre RODRIGUES ; Marina Vasconcelos SAMPAIO ; Antônio Carlos Delgado SAMPAIO ; Roberto Da Justa PIRES NETO ; Jorge Luiz Nobre RODRIGUES
Asian Pacific Journal of Tropical Medicine 2019;12(5):239-243
Rationale: Parsonage-Turner syndrome is a rare syndrome of unknown etiology, affecting mainly the lower motor neurons of the brachial plexus. Chikungunya fever is a mosquito-borne viral disease characterized by acute fever and polyarthritis/polyarthralgia. Patient concerns: A 54-year-old Brazilian male patient who presented with a 2-day history of fever (temperature 38.8 °C), arthralgia, erythematous rash, diffuse osteomuscular pain and headache, which evolved into left shoulder pain associated with morning stiffness. Diagnosis: Parsonage-Turner syndrome and chikungunya fever. Interventions: Symptomatic treatment (a combination of short-acting dypirone (500 mg every 6 h) and slow-release opioids (tramadol 100 mg every 4 h) and physiotherapy/rehabilitation with improvement. Outcomes: The patient was improved and discharged, remaining with symptomatic treatment and physiotherapy/rehabilitation. Lessons: To the best of our knowledge, there were no reports of Parsonage-Turner syndrome following chikungunya virus infection. Awareness of the possibility of this rare association is important. The present case report highlights the importance of awareness of this association as a new cause of morbidity in patients with chikungunya virus infection.
2. Clinical outcomes of hospitalized patients with chikungunya fever: A retrospective analysis
Lucas Lobo MESQUITA ; Enio Simas MACEDO ; Sérgio Luiz Arruda Parente FILHO ; Francisca Lillyan Christyan Nunes BESERRA ; Evelyne Santana GIRAO ; Juliana Mandato FERRAGUT ; Roberto Da Justa Pires NETO ; Geraldo Bezerra DA SILVA JÚNIOR ; Elizabeth DE FRANCESCO DAHER
Asian Pacific Journal of Tropical Medicine 2021;14(4):183-186
Objective: To describe the prognostic and clinical profile of hospitalized patients with chikungunya virus (CHIKV) infection focusing on renal outcomes. Methods: This is a cross-sectional study including all patients with confirmed chikungunya fever (CHIKF) admitted to 3 different high-complexity hospitals in Fortaleza, Brazil between January 2016 and June 2017. Data analysis was carried out to evaluate correlation between clinical profile and outcomes. Results: Fifty-five patients were included, with a median age of 77 (IQR=21) years, and 23 (41.82%) were male. Twenty-five patients (45.45%, 25/55) developed acute kidney injury (AKI), and 15 (60.00%, 15/25) were classified as KDIGO 1, 1 (4.00%) as KDIGO 2, and 9 (36.00%) as KDIGO 3. The overall mortality was 34.54% whilst AKI-related mortality was 64.00% (16/25). Both AKI and encephalitis were associated with higher mortality. Patients who died were significantly older [82 (IQR=12) years vs. 70 (IQR= 28.75) years, P<0.001)]. In the multivariate analysis, abdominal pain was associated with an increased risk of severe AKI (OR=5.33, 95% CI=1.11-25.64, P=0.037) and AKI was an independent risk factor of death (OR=12.06, 95% CI=2.55-57.15, P=0.002). Recovery of renal function was similar among the different age groups. Conclusions: AKI is present in half of the study population and is an independent risk factor of death. Thus, renal function should be carefully monitored in hospitalized patients with CHIKV infection.
3. Acute kidney injury in leptospirosis: Overview and perspectives
Geraldo DA SILVA JUNIOR ; José PINTO ; Geysa FARIAS ; Renan ALENCAR ; Nattachai SRISAWAT ; Nattachai SRISAWAT ; Gabriela GALDINO ; Ênio MACEDO ; Roberto PIRES NETO ; Elizabeth DE FRANCESCO DAHER ; Elvino BARROS
Asian Pacific Journal of Tropical Medicine 2018;11(10):549-554
Leptospirosis is a bacterial disease disseminated through the centuries in the whole world which causes symptoms that go from self-limited diseases to hemorrhagic manifestations and organ failure, including acute kidney injury (AKI), composing the severe disease known as the Weil's syndrome. Mortality rates varies according to the clinical presentation and usually increases when kidney injury is present, and is even higher in the setting of pulmonary hemorrhage. There are recent advances in the search for novel biomarkers of renal involvement and early detection of AKI in leptospirosis, as well as in its pathophysiology. We review in this article the clinical aspects of leptospirosis-associated AKI and the perspectives for future research.